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Autoimmune Encephalitis beyond NMDA-R Antibodies

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Autoimmune Encephalitis beyond NMDA-R Antibodies Josep Dalmau (SJD Barcelona Children's Hospital, Spain)

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March 27, 2021
Language
English
Speaker
  • Josep Dalmau
Cost
Free
Series
ICNTN
CPD/CME Credits
VOD
Yes

Autoimmune Encephalitis beyond NMDA-R Antibodies
Josep Dalmau (SJD Barcelona Children's Hospital, Spain)

Autoimmune encephalitis is a new category of diseases in which autoantibodies against neuronal cell surface and synaptic proteins cause a wide variety of syndromes and diseases resulting in neuropsychiatric manifestations. The spectrum of diseases, comorbidities and triggers is different between adults and children and symptoms vary according to the type of autoantibody. In children the most frequent autoimmune encephalitis is anti-NMDAR followed by a few others such as anti-MOG (myelin oligodendrocyte glycoprotein), anti-GABAaR, and other. In this presentation I will review the spectrum of these diseases in children, some of the underlying pathogenic mechanisms involved, and the approaches to treatment.

Learning Objectives

  • Clinically recognize anti-NMDA receptor and other autoimmune encephalitis
  • Optimally manage the initial treatment approach of anti-NMDAR encephalitis
  • Describe the underlying antibody-mediated pathogenic mechanisms in anti-NMDAR and other types of autoimmune encephalitis.

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  • This commment is unpublished.
    Reza Shervin Badv · 26 days ago
    Thanks for the amazing talk. Do you agree with the idea which suggests early co-administration of corticosteroids and Acyclovir in treatment of HSV encephalitis to prevent post "HSV AE"? Thanks, Reza Shervin Badv, Tehran, Iran.
  • This commment is unpublished.
    serap bilge · 24 days ago
    ı had a patient who had only psychotic issues, for 7 months, he started to ignore hım self by not eating well not having a bath...we sent a sample for autoımmune ımmune encephalıtıs he was positive for NMDA
    AFTER THAT PEDİATRİC PSYCHIATRY STARTED TO SEND ALL THEİR PATİENTS TO US TO EXCLUDE AUTOIMMUNE İSSUES

    SO IAM ASKING DO WE HAVE TO SEND A PANEL IN ALL PATEİNTS WHO ARE HAVİNG PSYCHİARTİC PROBLEMS,
    THANK YOU
  • This commment is unpublished.
    Elham Pourbakhtyaran · 25 days ago
    Thanks for the great presentation. By the way, how long we should wait for response to each part of first line treatment and when we turn to second line?
  • This commment is unpublished.
    Tanveer Irshad Siddiqui · 26 days ago
    Thank you for the wonderful talk.

    I also have similar Do we consider ALERD ( Acute leuco-encephalopathy with restricted diffusion) and MLC as one of the autoimmune encephalitis, amenable to immunosuppression
  • This commment is unpublished.
    loreto Rios-Pohl · 26 days ago
    Thank you for the excellent presentation.
  • This commment is unpublished.
    Iris Noyman · 26 days ago
    if a patient was diagnosed wuth post herpes anti NMDA encephalitis treated with monthly IVIG and pulse steroids and improved but still having seizures and hippsarrhthmia. parents refused rituximab in the past. 2 years have past - would you check antibodies again and try rituximab or just give it ( they ARE WILLING TO TRY TREATMENT NOW)
  • This commment is unpublished.
    Issam Alkhawaja · 26 days ago
    Issam Khawaja from Jordan Thank you very much for this interesting lecture. If you consider the benefit of using low-dose prednisolone for the long term (several months) when we achieve partial response to first line therapy and no availability of second line therapy ??
  • This commment is unpublished.
    Dr. Kavita Srivastava · 26 days ago
    Thank you for the wonderful talk. Do we consider ALERD ( Acute leuco-encephalopathy with restricted diffusion) as one of the autoimmune encephalitis, amenable to immunosuppression? Dr. Kavita Srivastava, India
  • This commment is unpublished.
    Ricardo De Moraes Ribeiro · 26 days ago
    If the event that a 5 years Child does not present Delta brush during the disease but during the evolution (18 months later) we find it in a finding in a control EEG, What behavior do you suggest to take? Thanks. Greetings from Uruguay.
  • This commment is unpublished.
    Pimchanok Kulsiricha · 26 days ago
    For the relapsed antiNMDA receptor encephalitis, Which one do you prefer for prevent the next episode?
  • This commment is unpublished.
    loreto Rios-Pohl · 26 days ago
    Do you agree in considering FIRES a subtype of NORSE. Autoinmune Encephalities would be a subtype of FIRES or NORSE? Why Celici consider FIRES a diferential diagnostic?? wouldn´t be a cause of the FIRES? Loreto Ríos-Pohl , Chile . South America
  • This commment is unpublished.
    Sheffali Gulati · 26 days ago
    Thanks for an excellent presentation. For how long can antibody positivity persist in children in the refractory cases as we have had few such sort of super refractory cases who remain symptomatic. Sheffali Gulati, New Delhi, India
  • This commment is unpublished.
    Ricardo De Moraes Ribeiro · 26 days ago
    If the event that a 5 years Child does not present Delta brush during the disease but during the evolution (18 month later) we find it in a finding in a control EEG, What behavior do you suggest to take? Thanks.
  • This commment is unpublished.
    Serap Bilge · 26 days ago
    ı have a ptient he had only psychotıc problems for months...but we decıded to send for lımbc encephalıtıs panel...he was autoımmune encephalıtıs when to send a sample ın psychotıc patienys
  • This commment is unpublished.
    Pelagia Vorgia · 26 days ago
    Do you propose for every herpes encephalitis to mesuare anti NMDAR the 21th day of treatment?
  • This commment is unpublished.
    Vanita Shukla · 26 days ago
    Excellent presentation! Has there been an increase in cases of autoimmune encephalitis related to SARS CoV2 and if so, what is the prognosis? Vanita Shukla, Trinidad and Tobago
  • This commment is unpublished.
    Dr Banu Anlar · 26 days ago
    Why do some children develop NMDAR encephalitis after herpes simplex encephalitis but the others not?What is your opinion?
  • This commment is unpublished.
    Hula Shareef · 26 days ago
    I have patients with AMDAR encephalitis show very good responce when I start IVIG after IVMP So can I keep his on monthly IVIG
  • This commment is unpublished.
    Dominique Enyama · 26 days ago
    Is there a specific antiepileptic you prefer for the treatment of seizures in the accute phase of NMDA-R encephalitis? And How long to you keep these after recovery? Dominique Enyama, Douala, Cameroun
  • This commment is unpublished.
    loreto Rios-Pohl · 26 days ago
    In what stage would you put ketogenic Diet in autoinmune encephalitis?

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